Arthroscopy: Past, present, and the future

I must begin by expressing my sincerest thanks to Prof. Raju Vaishya and the Indian Arthroscopy Society (IAS) for bestowing me with the honor of guest editing the inaugural issue of the Journal of Arthroscopic Surgery and Sports Medicine (JASSM); I am truly humbled. A significant amount of work has gone on behind the scenes to make this happen, but I have certainly been impressed by the efficiency and work ethic of the publishers, and as I am sure you are well aware of the Editor-in-Chief.

The development of endoscopic technology in a surgical setting is often attributed to Philipp Bozzini, a German military surgeon attempting to locate bullets in the bodies of his patients. By 1806, he had developed the “Lichtleiter,” which although crude is unmistakably the ancestor of modern arthroscopes.^[1] It took another 100 years for the science to move on to the assessment of joints with recorded instances of knee arthroscopy taking place in Denmark and Japan in the second decade of the 20^th century.^[2] Despite an initial focus on the use of the surgery for the larger joints, with the evolution of surgical instruments, surgeons were able to apply the techniques and technology to the smaller joints of the foot and ankle and wrist.^[3]

Although the notion behind “arthroscopy” is 100 years old, and the concept of endoscopic science over 200 years old, in most parts of the world, arthroscopy is still “young.” With an explosion of use and popularity in the last two decades, the procedure is more relevant now than ever and is applied ever more widely to patients of all ages and occupations across the globe. Research and interest in it as a successful means of diagnosing and treating joint conditions are as heightened as ever. With its great advantage of being a minimally invasive procedure, arthroscopy has always had the potential to improve and change the lives of patients whose quality of life has hitherto been low or painful. In the case of athletes, construction workers, and other physical laborers, the procedure has the potential of even saving a career.

In India, the procedure has been used since 1979, and the IAS was formed in 1983 under the guidance of Dr. Dinesh Patel. Since then, the spread of arthroscopy in India has been unbounded with the support of society and continues to grow. Despite its reputation training young arthroscopic surgeons in India in particular, the annual IAS Congress (IASCON) now attracts thousands of delegates and speakers from across the world. Once again, I must express my gratitude at being asked to be part of the launch of this journal, the flagship of such a prestigious and worthy society.

For this first issue of JASSM, we have planned 20 articles from key opinion leaders in India, the UK, the USA, Italy, South Africa, Dubai, and Australia. These reviews cover the history of arthroscopy, recent advances, and future trends and encompass the whole spectrum of arthroscopy for each joint. In a fascinating article, which I know will pique many readers’ interest, Rajan et al.^[4] travel through time to tell the story of arthroscopy in India, whilst Baker et al.^[5] bring the history of wrist arthroscopy to life in a colorful article packed full of figures and photographs, old and new. Held et al.^[6] leave the past behind, and in an original and highly valuable article, discuss those advances and trends in multi-ligament injuries of the knee relevant to surgeons in countries with lower economic resources. A pair of papers on the relatively new technology behind regenerative^[7,8] orthopedics will catch the eye of many readers, I am sure, covering both its history in orthopedics and a discussion of the discipline’s future.

With the global reach of its contributors and subsequent global view of the procedure, we hope that this issue will act as a key reference guide for many surgeons for many years to come, be you a shoulder, elbow, wrist, hip, knee, foot and ankle, spine, or regenerative orthopedic specialist. I hope you enjoy each and every article in this issue; it is been a privilege and a pleasure putting it together.

The publication of the JASSM is a landmark step for IAS, one that I am incredibly proud to be part of the inaugural issue, and I really believe that this issue will contribute scientifically to the field and growth of arthroscopy not only in India but internationally. Going forward, I wish the best of luck to both the society and the journal; if the beginning of the journey is anything to go by, both have a bright future!